PTSD – What Happens in the Brain?

Post-traumatic stress disorder (PTSD) is one of the potentially devastating effects that may follow on from childhood trauma, and, in this context, the condition is frequently referred to as ‘complex PTSD.’ But what is actually happening inside of the brain in individuals who are suffering from this most serious condition?

To answer this question, it is necessary to look at two particular brain structures; these are :

1) THE AMYGDALA -this structure can be viewed as the brain’s ‘FEAR CENTRE’

2) THE HIPPOCAMPUS – this structure is able to activate/deactivate the amygdala

Next, it is necessary to understand that :

under stress, the body produces two hormones called ADRENALINE and CORTISOL :

The functions of these two hormones are as follows:

– ADRENALINE – this produces physical responses to stress such as increased heart rate and sweating

– CORTISOL – this flows to the hippocampus and at first helps to lay down the memory of the trauma, but, in excessive quantities over sustained periods of time, it can damage the hippocampus, causing its cells to degenerate and, eventually, die. This process is called APOPTOSIS.

Indeed, if the traumatic experience is severe enough these biological changes in the brain (ie the excessive production of neurotoxins such as cortisol) can cause the hippocampus, in effect, to shut down.

This means it can no longer regulate or switch off the FEAR PRODUCING AMYGDALA, causing the latter brain structure to go into overdrive.

Thus, a situation arises in which the AMYGDALA BECOMES OVERACTIVE DUE TO THE UNDERACTIVITY OF THE HIPPOCAMPUS. Without proper intervention, this state of affairs may persist for many years.

The processes described above can lead to what has been called a TRAUMATIC CASCADE, causing the individual to feel a constant state of hyper-arousal, hyper-vigilance, anxiety and fear, perceiving danger, or the threat of danger, everywhere.

IMPLICATIONS FOR TREATMENT :

In such a poor and intensely painful emotional state, it is not possible for the individual to start properly processing, in a therapeutic manner, his/her experiences of trauma. This prevents the recovery process from getting underway.

In order to rectify this, a vital step, before therapeutic processing of traumatic experiences can begin, is to bring these constant feelings of fear and anxiety down to a level at which they are at least manageable. This may involve the prescribing of appropriate medication, behavioural techniques, or a combination of the two.

Indeed, studies involving both humans and animals have shown that such interventions can lead to the recovery of the hippocampus so that, once again, it may begin to regulate the amygdala as intended and alleviate excessive and superfluous feelings of fear and anxiety.